Yolanda Galaz
Tucson ,AZ
Summary
With a proven track record at La Frontera Center Arizona, I excel in enhancing billing processes and team productivity through strong analytical abilities and effective team building. My expertise in claims processing and adaptability to change has significantly improved operational efficiency, embodying professionalism and ethics in all endeavors.
Overview
29
29
years of professional experience
Work History
Senior Billing Specialist
La Frontera Center Arizona
12.2020 - Current
- Import electronic payments form clearinghouse, post EOB's resolve/resubmit denials and adjustments and monitor for denial trends.
- Process claims with AHCCCS, Medicare and other insurance company claims.
- Generate electronic billing files to insurance payers.
- Verify client eligibility and perform pre-billing audits
- Assist with special projects that may involve coordination gathering and reporting data.
- Continually look for opportunities to improve billing processes, communicate findings with Billing Manager.
- Review outstanding accounts receivable and resolve to collect past due balances.
- Analyze procedure codes to ensure that bills are complete.
- Process adjustments and denials, and resubmit bills according to EOB and further analysis.
- Participated in regular training sessions, staying up-to-date with the latest industry trends, tools, and best practices, ultimately enhancing job performance.
- Proactively identified potential billing issues by regularly reviewing contract terms and conditions for accuracy and consistency.
- Increased team productivity by delegating tasks effectively based on individual strengths and workload capacity.
- Demonstrated strong attention to detail by identifying and correcting minor errors before they escalated into major issues, contributing to overall accuracy in billing processes.
- Conducted thorough audits of client accounts to identify discrepancies, enabling prompt resolution of any issues.
- Audited and corrected billing and posting documents for accuracy.
- Maintain strict confidentiality related to medical records and other client related data.
- Maintain proficiency with the clinical software. Excel and general ledger software.
Billing Specialist
La Frontera Center Arizona
06.2018 - 12.2020
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Generate electronic billing files to insurance payers.
- Process claims with AHCCCS, Medicare and other insurance company claims.
- Import electronic payments from clearinghouse, post EOB's resolve/resubmit denials and adjustments and monitor denials.
- Recommend/implement processes revision processes to reduce errors prior to billing and in future claim submissions.
- Assist with special projects that may involve coordination, gathering and reporting data.
- Analyze procedure codes to ensure that bills are complete and accurate prior to release.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Managed monthly billing cycles to ensure timely issuance of invoices and statements.
- Reduced errors in financial records by conducting regular audits of billed accounts.
- Used data entry skills to accurately document and input statements.
- Created improved filing system to maintain secure client data.
- Review outstanding accounts receivable and resolve to collect past due balances.
- Process adjustments and denials, and resubmit claims according to EOB and further analysis.
- Maintain strict confidentiality related to medical records and other client related data.
- Assist billing staff with questions and error resolution.
Production Analyst
La Frontera Center Arizona
01.2010 - 06.2018
- Participated in continuous improvement initiatives aimed at enhancing overall operational efficiency within the organization.
- Collaborated with cross-functional teams to identify opportunities for process improvement, resulting in increased productivity.
- Increased production efficiency by streamlining processes and implementing improvements.
- Provided support to the production team, ensuring timely completion of projects and adherence to deadlines.
- Identified areas for cost reduction and optimized budgets in the production department.
- Supported training initiatives by developing comprehensive documentation on key processes within the department''s purview.
- Enhanced product quality with rigorous testing and monitoring procedures.
- Process claims on a daily basis, works denials and resubmissions.
- Provided daily support with escalated ticket resolution and liaised with business and technical leads.
- Identified root causes of recurring problems to implement effective solutions.
- Reported on findings and made proactive and targeted recommendation to senior leaders.
- Worked closely with test, development and requirements team members to analyze, investigate and resolve common issues.
- Analyze data and reporting.
- Maintain strict confidentiality related to medical records and other client related data.
Intake/Closure Specialist
La Frontera Center Arizona
09.2005 - 09.2014
- Followed all company policies and procedures to deliver quality work.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
- Collaborated with cross-functional teams to achieve project goals on time and within budget.
- Implemented new training programs for staff, leading to higher employee retention rates and better overall performance.
- Led quality assurance efforts, maintaining high standards for all products and services.
- Verification members AHCCCS eligibility/Medicare/Commercial Insurance.
- Generated daily upload into CPSA System.
- Completed Closures/Enrollments /Annual assessments into Pace System.
- Collected, arranged, and input information into database system.
- Generated reports detailing findings and recommendations.
- Maintain strict confidentiality related to medical records and other client related data.
Clinical Operation Support Staff
La Frontera Center Arizona
10.1995 - 09.2014
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Worked flexible hours across night.
- Managed time efficiently in order to complete all tasks within deadlines.
- Organized and detail-oriented with a strong work ethic.
- Paid attention to detail while completing assignments.
- Learned and adapted quickly to new technology and software applications.
- Proved successful working within tight deadlines and a fast-paced environment.
- Developed and maintained courteous and effective working relationships.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- AHCCCS application and basic computations to determine sliding fee scale and eligibility.
- Fax machine/scanning.
- Scheduled appointments and maintain and update appointment calendars.
Education
General Studies
Pima Community College
Tucson, AZ09-1990
High School Diploma -
Pueblo High School
Tucson, AZ06-1987
Skills
- Adaptability to Change
- Strong Analytical Abilities
- Accurate data entry
- Professionalism and Ethics
- HIPAA Compliance Understanding
- Team building
- Proven Problem Solving
- Efficient time management
- Billing systems and software
- Claim submission
- Claims Processing
- Data entry proficiency
- Payment posting
Accomplishments
Promotion Production Analyst, 2014
Outstanding Achievement in Customer Satisfaction, 2005
Timeline
Senior Billing Specialist
La Frontera Center Arizona
12.2020 - Current
Billing Specialist
La Frontera Center Arizona
06.2018 - 12.2020
Production Analyst
La Frontera Center Arizona
01.2010 - 06.2018
Intake/Closure Specialist
La Frontera Center Arizona
09.2005 - 09.2014
Clinical Operation Support Staff
La Frontera Center Arizona
10.1995 - 09.2014
General Studies
Pima Community College
High School Diploma -
Pueblo High School
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